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NYT Examines Effects Of Illegal Abortion On Maternal Mortality In Tanzania
The New York Times on Tuesday examined how botched abortion procedures contribute to maternal mortality in Tanzania, in the second of a three-part series on pregnancy- and childbirth-related deaths in the country. The Times reports that the lack of abortion rights in Tanzania -- where the procedure is illegal except in cases where the woman"s life or health is at risk -- has prompted pregnant women and girls to seek the procedure from people who have not been trained to perform such procedures. In some cases, these untrained providers give the pregnant women herbs before performing abortions by punching the pregnant women"s stomachs or inserting objects into the vagina and uterus. Local hospitals in Tanzania often have to correct mistakes made by the untrained abortion providers. For example, during the month of January, 17 of the 31 minor surgical procedures performed at one Tanzanian hospital were to correct the results of "incomplete abortions."Africa has the world"s highest maternal mortality rate -- at least 100 times that of developed countries -- making pregnancy and childbirth among the most serious health dangers that African women face, according to the Times. Abortion accounts for a significant portion of those deaths. Tanzania has a maternal mortality rate of 950 deaths for every 100,000 births, a figure that is "neither the best nor the worst in Africa," the Times reports.Because most abortions in Tanzania are performed illegally, there are no reliable abortion figures for the country. However, the World Health Organization estimates that Eastern Africa, where Tanzania is located, has the world"s second-highest rate of unsafe abortions. Abortion rates typically decrease with increased contraceptive use, the Times reports. Only about one-quarter of Tanzanians use contraception in part because of misinformation that girls receive about the safety of condoms and hormonal contraceptives. By comparison, Kenya and South Africa both have higher contraception use and lower maternal mortality. However, in countries such as Sierra Leone and Nigeria, where abortion is not available on request, contraception use is lower than in Tanzania, and maternal mortality is much higher (Grady, New York Times, 6/2).
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Blood Pressure Can Be Lowered By Reducing Salt Intake
Adults who use less salt in their diet can experience a slight reduction in their blood pressure in the medium term. However, whether in the long term this can also reduce the risk of late complications in people with sustained high blood pressure, otherwise known as essential hypertension, and whether in the long term their anti-hypertensive medication can be reduced remains unresolved. This is the conclusion of the Institute for Quality and Efficiency in Health Care (IQWiG) in its final report published in the form of a rapid report on 20 July 2009.
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Health Affairs And RWJF Launch Health Policy Briefs With Look At Medicare Advantage
Health Affairs and the Robert Wood Johnson Foundation (RWJF) are pleased to announce a new series of Health Policy Briefs aimed at providing clear, accessible overviews of timely and important health policy topics. The first brief explores the current debate over cutting payments to Medicare Advantage plans - the privately run health plans that now serve almost a quarter of Medicare enrollees.
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Health Subcommittee Considers Bill To Eliminate Pre-Emption For Medical Devices

The House Energy and Commerce Health Subcommittee on Tuesday heard testimony on the Medical Device Safety Act of 2009 (HR 1346), which would allow consumers to sue medical device manufacturers in state courts, CQ HealthBeat reports. The bill responds to last year"s Supreme Court ruling that says medical devices with FDA pre-marketing approval can be pre-empted from lawsuits under state law, in accordance with the Medical Device Amendments of 1976. Rep. Frank Pallone (D-N.Y.), who introduced the bill, said that the 2008 Supreme Court ruling "ignor[ed] congressional intent" by providing blanket immunity for medical device makers. According to Rep. John Dingell (D-Mich.), a co-sponsor of the bill, the original 1976 law sought to grant regulatory authority to FDA for medical devices, but it did not aim to eliminate state liability. Committee Chair Rep. Henry Waxman (D-Calif.), another co-sponsor, said last year"s ruling already has caused 1,400 injury cases to be thrown out of court, adding that the threat of litigation provides manufacturers with additional safety incentives. David Vladeck -- a law professor at Georgetown University Law Center who testified at the hearing -- added that immunity from lawsuits "removes incentive to manufacturers to fix devices quickly and get defective devices off the market."Rep. Nathan Deal (R-Ga.) said the class of device that must obtain pre-marketing approval -- which includes pacemakers and replacement heart valves -- represents only 2% of all approved medical devices each year. Rep. Michael Burgess (R-Texas) added that the measure could create an inconsistent system that allows both FDA experts and jurors in various states to make decisions on medical device safety standards. In addition, Rep. Joe Pitts (R-Pa.) cautioned that the bill might encourage manufacturers to limit distribution of their devices to certain states (Kim, CQ HealthBeat, 5/13). Related Editorial The Medical Device Safety Act would allow consumers to "reap financial awards" from medical device safety lawsuits, even though FDA "approved the labeling used on the devices," a Washington Times editorial states. It continues that although the bill"s supporters "cite horror stories about injured patients," opponents contend that "manufacturers should not be held hostage to inexpert juries in 50 different states under 50 different state laws when the experts at the FDA already have told them what the labels must say." The editorial states that the proposed legislation would "kill innovation" because manufacturers would be "far less likely" to market a medical device if they "know they will be subject not just to regulation by the FDA but to uncertain justice under 50 different state standards." The editorial concludes, "The Medical Device Safety Act favors litigious trial lawyers over sick patients. Its passage would amount to serious legislative malpractice" (Washington Times, 5/14). Broadcast Coverage NPR"s "Morning Edition" on Wednesday reported on issues related to medical device safety and lawsuits against manufacturers (Silberner, "Morning Edition," NPR, 5/13). Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.


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